Crum & Forster

What they litigate

Disputed issues across the decisions this claims administrator is named in. Every row opens the decisions it counts.

Where they appear

• Van Nuys 9
• Santa Ana 5
• Riverside 3
• San Francisco 3
• Los Angeles 2
• Anaheim 1
• Lodi 1
• Long Beach 1
• Los Angles 1
• Marina del Rey 1
• Oakland 1
• Pomona 1

How the appealed decisions came out

These are decisions that were appealed and published — the tail of a system that mostly settles. Most claims end in a compromise and release or a stipulation and never reach a panel, so nothing below describes how this claims administrator does its work. It describes how a set of appealed disputes came out.

• 13 for the applicant
• 12 for the defense
• 3 returned for more record

Counted over 28 appealed decisions. Not this claims administrator’s book of work.

Decisions

Newest decisions this claims administrator is named in, each with the passage the panel turned on and a link to the official PDF.

• ADJ19126786 · 2026-01-20 · Oakland District OfficePermanent disability ratingapplicant prevailed

  Determinative passage · p.5INTRODUCTION By a timely and verified Petition for Reconsideration (Petition) filed on August 22, 20251, defendant seeks reconsideration of my July 31, 2025 Joint Findings, Award and Order, wherein I found, among other things, that applicant, while employed1 on September 30, 2016 (ADJ19126786) as an office assistant/secretary (Occupational Group 211) at San Jose, California, by Mobile Home Communities of America, Incorporated, sustained injury arising out of and in the course of employment to the bilateral shoulders, bilateral knees, cervical spine, lumbar spine, and thoracic spine, but did not sustain injury to the bilateral ankles, causing permanent disability of 59% after apportionment. I also found that applicant did not sustain a cumulative trauma to the same body partes during the cumulative trauma period ending on September 30, 3016 in ADJ19126787. In reaching my decision, I relied on the report of one of the Qualified Medical Examiners in this case, Dr. Rabeah Emanour, whose opinion I found mor persuasive and logical than the other QME in these cases. Dr. Eric Carlblom.

  The WCJ found the opinion of Dr. Emampour more persuasive and logical than Dr. Carlblom's, supporting a 59% permanent disability rating after apportionment. The Appeals Board agreed, finding Dr. Emampour's opinion substantial evidence and denying the defendant's petition to reduce the rating or admit a supplemental report.

  Official decision · page 5 →
• ADJ6508173 · 2026-01-16 · Marina del Rey District OfficePermanent disability ratingdeferred

  Determinative passage · p.2We have considered the allegations in applicant's Petition and defendant's Answer, and the contents of the WCJ's Report with respect thereto. Based upon our review of the record, and for the reasons discussed below, as our Decision After Reconsideration, we will rescind the F&A, and substitute a new F&A that finds that applicant sustained injury to her lungs, upper digestive system (in the form of gastroesophageal reflux disease (GERD), psyche and in the form of a sleep disorder, but not in the form of METs because it is a measure of functional limitation and not a separate body part; and to defer the issue of permanent disability, apportionment and attorney fees, and the issue of whether the increase under section 4658(d) applies.

  The Board found injury to lungs, upper digestive system (GERD), psyche, and sleep disorder but not to METs, which is a measure of functional limitation, not a body part. The issue of permanent disability, apportionment, and the 15% increase under section 4658(d) was deferred for further development due to incomplete medical opinion and need for further record development.

  Official decision · page 2 →
• ADJ13002614 · 2026-01-05 · San Francisco District OfficeQME/AME processdefendant prevailed

  Determinative passage · p.1Applicant seeks reconsideration, or in the alternative, removal of the Findings and Order (F&O) issued on October 1, 2025, wherein the workers' compensation administrative law judge (WCJ) found, in relevant part, that while employed by defendant on January 11, 2020 as a rental leasing consultant, applicant sustained an injury arising out of and in the course of employment (AOE/COE) to the cervical spine, lumbar spine, bilateral shoulders, bilateral wrists (carpal tunnel syndrome), and psyche. The WCJ further held that panel 3448334 is valid; applicant's December 9, 2024 selection of Hosein Tahami, D.O. as the psyche panel Qualified Medical Evaluator (PQME) from said panel was premature; the parties April 3, 2024 agreement to continue use of Jeffrey Gould, M.D. as the psyche PQME was in effect until its termination on December 6, 2024; and the time frame during which the parties were to commence the striking process for panel number 3448334 was October 1, 2025--the date of service of the F&O.

  The WCJ found the applicant's selection of Dr. Tahami premature because the striking period for the QME panel started anew on December 6, 2024, and had not expired by December 9, 2024, when the applicant selected Dr. Tahami.

  Official decision · page 1 →
• ADJ19575926 · 2025-06-30 · Pomona District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.7This claim is straightforward. Though applicant was no longer "on the clock," he was performing the task for which he was hired by the defendant, caring for the patient, while still on the premises to which he was assigned by the employer. It is certainly anticipated by the employer that applicant should have continued to assist the patient, who struggled with balance, with walking to bed even though he had already clocked out for his shift. In fact, no testimony was elicited as to any policies the employer may have had for caretaking, clocking out, or even staying beyond one's shift. Given the nature of the employment, the employer could not have expected that applicant

  Applicant was performing a task for which he was hired, caring for the patient, while still on the employer's premises, and such activity was reasonably anticipated by the employer even though applicant had clocked out. No evidence showed applicant was acting inconsistently with his employment.

  Official decision · page 7 →
• ADJ16473370 · 2025-01-21 · Van Nuys District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.12Hence the preponderance of the evidence shows that Command was the Applicant's employer on the date of injury.

  The preponderance of the evidence shows that Command International Security was the applicant's employer on the date of injury, based on applicant's testimony, corroborating testimony from the project manager, text messages, and lack of evidence of employment or payment by Prestige.

  Official decision · page 12 →
• ADJ13428207 · 2024-11-18 · Los Angeles District OfficeReopening / new and further disabilityremanded

  Determinative passage · p.6With respect to the finding that applicant's claim is barred by the five-year statute of limitations under section 5410, we note that the defense of statute of limitations is an affirmative one. Defendant bears the burden of proving same. (Lab. Code, § 5409; Kaiser Found. Hosps. Permanente Medical Group v. Workers' Comp. Appeals Bd. (1985) 39 Cal.3d 57, 67, fn. 8 [50 Cal.Comp.Cases 411] ["The running of the statute of limitations is an affirmative defense (§ 5409), and the burden of proving it has run, therefore, is on the party opposing the claim."].) On this existing record, it appears that the defendant has failed to prove that the filing of the petition to reopen is untimely.

  The record was insufficient to determine the date of injury or whether the petition to reopen was timely; the defense failed to meet its burden to prove untimeliness, so the matter was remanded for further record development.

  Official decision · page 6 →
• ADJ10808328 · 2024-11-15 · San Francisco District OfficeMedical treatment / UR / IMRdefendant prevailed

  Determinative passage · p.6As part of my August 16, 2024 Findings, Award and Order, I did order further development of the record on the issue of applicant's claim for reimbursement for self- procured medical expenses. Labor Code section 4600(e) provides for reasonable expenses for transportation, meals, and lodging incident to a medical- legal examination, along with payment for each day of lost wages in connection with the examination. To the extent that the transportation expenses are self- procured medical expenses, I have already ordered further development of the record on the issue.

  The issue of reimbursement for QME travel expenses was not raised at trial and no evidence was presented. Further development of the record on self-procured medical expenses was already ordered; reconsideration is not appropriate for a non-final order.

  Official decision · page 6 →
• ADJ11387739 · 2024-09-10 · Lodi District OfficeApportionmentdefendant prevailed

  Determinative passage · p.2The parties have selected F. Karl Gregorius, M.D., as the QME in neurosurgery. On April 24, 2024, the parties proceeded to trial. The parties stipulated therein to applicant's injury as having arisen out of and in the course of employment, and to injury to the bilateral wrists, elbows, and in the form of thoracic outlet syndrome. (Minutes of Hearing (Minutes), dated April 24, 2024, at p. 2:8.) The parties further stipulated, in relevant part, to the scheduled rating of the reporting of QME Dr. Gregorius, and to applicant's entitlement to future medical care to the bilateral wrists, elbow, and for applicant's thoracic [outlet] syndrome. (Id. at p. 2:38.) The sole issue framed by the parties was the "applicable apportionment" of QME Dr. Gregorius. The WCJ provided the parties with additional time in which to file trial briefs, and ordered the matter submitted for decision on May 22, 2024. On June 17, 2024, the WCJ issued the F&O, ordering in relevant part the appointment of Jonathan Rutchik, M.D., as a regular physician pursuant to Labor Code section 5701. The WCJ's Opinion on Decision notes that while the WCJ found the opinions of QME Dr. Gregorius to be well-reasoned, the QME stated in his deposition testimony that he was not an expert, and that the QME's reports and testimony did not rise to the level of substantial evidence.

  The WCJ found the QME's apportionment analysis inconsistent and not substantial evidence, leading to appointment of a regular physician with expertise in thoracic outlet syndrome. The Appeals Board concurred and denied reconsideration, finding no error in the WCJ's weighing of evidence.

  Official decision · page 2 →
• ADJ number not stated · 2024-08-30 · Van Nuys District OfficeLiensapplicant prevailed

  Determinative passage · p.7Accordingly, there is sufficient evidence in the existing record to find that lien claimant did rebut the presumption "affecting the burden of proof" in section 139.21(g) that her lien claims "and all underlying bills for service and claims for compensation asserted therein, [arose] from the conduct subjecting the physician, practitioner, or provider to suspension..." (Lab. Code, § 139.21(g).)

  The Appeals Board found that lien claimant rebutted the presumption under Labor Code section 139.21(g) because the fraudulent conduct for which she was convicted occurred in 2006, before she began treating workers' compensation patients in 2009, so the liens did not arise from the conduct subjecting her to suspension.

• ADJ10961161 · 2024-04-15 · Santa Rosa District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1We have considered the allegations of the Petition for Reconsideration, the Answer, and the contents of the WCJ's Report. Based on our review of the record, as our Decision After Reconsideration we will rescind the WCJ's July 15, 2022 F&O, and in its place, we will substitute a new findings of fact that applicant sustained industrial injury to her mouth, which resulted in no permanent disability and no need for future medical treatment.

  The Board found that applicant sustained industrial injury to her mouth based on medical evidence and rejected the WCJ's prior finding to the contrary.

  Official decision · page 1 →
• ADJ7912629 · 2023-09-27 · Santa Ana District OfficeTemporary disabilitydeferred

  Determinative passage · p.23In summary, we have previously provided notice of intention to affirm our June 12, 2018 Opinion and Order Granting Petitions for Reconsideration and Decision after Reconsideration except to amend the March 20, 2018 Findings and Award, to find that the issue of applicant's Permanent and Stationary date is deferred (Finding of Fact No. 5); that the issues of permanent disability, apportionment, and attorney's fees are deferred (Findings of Fact Nos. 6, 7, 15); and that the issue of the applicable rating schedule is deferred (Finding of Fact No. 10). We have further provided notice of our intention to rescind the WCJ's April 12, 2019 Findings and Award, and substitute a new Findings and Award reflecting that applicant's date of injury was March 20, 2014 (Findings of Fact No. 1); that applicant's disability must be rated using the AMA Guides, pursuant to section 4660.1 (Finding of Fact No. 2); that applicant's Permanent and Stationary date is March 20, 2014 (Finding of Fact No. 5); and that the issues of permanent disability, COLA adjustment, and attorney fees are deferred (Findings of Fact Nos. 6 & 7). We continue to exercise our original jurisdiction because there has been no prior final award of compensation. We further conclude that

  The Board deferred the issues of permanent disability, apportionment, attorney fees, COLA adjustment, and other issues for further proceedings.

  Official decision · page 23 →
• ADJ11273405 · 2023-07-31 · Riverside District OfficeMedical treatment / UR / IMRapplicant prevailed

  Determinative passage · p.1Lien Claimant RMS Medical Group (RMS) seeks reconsideration of the Findings and Order (F&O) issued by the workers' compensation administrative law judge (WCJ) on May 11, 2023, wherein the WCJ found in pertinent part that the issues regarding medical legal reimbursement, penalties and interest, and costs, have previously been addressed by the Appeals Board and therefore are moot; and that defendant has not acted in bad faith so RMS is not entitled to an award for Labor Code section costs and sanctions.

  The WCAB found that RMS was entitled to payment for medical-legal services plus statutory penalties and interest, but not entitled to costs and sanctions because defendant did not act in bad faith.

  Official decision · page 1 →

Also recorded as

The same claims administrator is printed several ways across the decisions, and all of them were counted as one. This is every spelling behind the figures above.

• CRUM & FORSTER
• Crum & Forster
• CRUM AND FORSTER
• Crum and Forster Insurance Company
• CRUM & FORSTER HOLDINGS CORP.
• CRUM & FORSTER INSURANCE
• Crum& Forster
• Crum Forster
• CRUM FORSTER

Is this your company and something here is wrong? Tell us and we will fix it. Every figure on this page is a count of released decisions this claims administrator is named in, and the decisions themselves are listed above with the passage each turned on.